Provider Demographics
NPI:1881034726
Name:DAVIES, JAMES PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILIP
Last Name:DAVIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST STE 1520
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4212
Mailing Address - Country:US
Mailing Address - Phone:918-900-2520
Mailing Address - Fax:
Practice Address - Street 1:2448 E 81ST ST STE 1520
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4212
Practice Address - Country:US
Practice Address - Phone:918-900-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34921207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK05069223Medicaid
SC36020OtherLIMITED LICENSE NUMBER